Avoiding Cigarette Smoking Research Articles

Kidney Stone Prevention

Kidney stone disease (KSD) (alternatively nephrolithiasis or urolithiasis) is a global health care problem that affects people in almost all of developed and developing countries. Its prevalence has been continuously increasing with a high recurrence rate after stone removal. Although effective therapeutic modalities are available, preventive strategies for both new and recurrent stones are required to reduce physical and financial burdens of KSD. To prevent kidney stone formation, its etiology and risk factors should be first considered. Low urine output and dehydration are the common risks of all stone types, whereas hypercalciuria, hyperoxaluria, and hypocitraturia are the major risks of calcium stones. In this article, up-to-date knowledge on strategies (nutrition-based mainly) to prevent KSD is provided. Important roles of fluid intake (2.5-3.0 L/d), diuresis (>2.0-2.5 L/d), lifestyle and habit modifications (for example, maintain normal body mass index, fluid compensation for working in high-temperature environment, and avoid cigarette smoking), and dietary management [for example, sufficient calcium at 1000-1200 mg/d, limit sodium at 2 or 3-5 g/d of sodium chloride (NaCl), limit oxalate-rich foods, avoid vitamin C and vitamin D supplements, limit animal proteins to 0.8-1.0 g/kg body weight/d but increase plant proteins in patients with calcium and uric acid stone and those with hyperuricosuria, increase proportion of citrus fruits, and consider lime powder supplementation] are summarized. Moreover, uses of natural bioactive products (for example, caffeine, epigallocatechin gallate, and diosmin), medications (for example, thiazides, alkaline citrate, other alkalinizing agents, and allopurinol), bacterial eradication, and probiotics are also discussed.

Health Behavior and Lifestyle Trends among Platelet Donors: Results from a Questionnaire-Based Survey in Norway.

Background Blood donors are on average healthier than the general population, a phenomenon known as the “healthy donor effect.” Earlier studies have also pointed to healthier behaviors among whole blood donors than the general population. This study is aimed at assessing the prevalence of four healthy behaviors (sufficient physical activity, avoiding cigarette smoking, low to moderate alcohol use, and maintaining a healthy weight) among platelet donors and to compare the results with those in the general population of similar ages. Methods Eighty-six platelet donors were asked to complete a questionnaire designed to assess physical activity, smoking, and alcohol use. Sociodemographic information including gender, age, and education was also collected from all participants. Chi-square statistics and logistic regression were used in statistical analysis. Results The mean age of the study donors was 51 years, 56% were female. Most were employed (90%), and 48% hold a bachelor's or higher degree. The prevalence of healthy behaviors differed by education gradients but not by gender and age. About 49% of the donors met the weekly physical activity recommendations, less than 5% were daily smokers, and~26% were classified as more frequent drinkers (≥1 to ≤5 times per week). The corresponding percentages for the general population were, respectively, 33%, 13%, and 35%. The prevalence of overweight and obesity, as assessed by body mass index (BMI), among donors were 50% and 29%, respectively, much higher than the current prevalence of overweight and obesity of 37% and 19%, respectively, among adults in the general population. Conclusions The individual health behaviors of the majority of the study population could be characterized by a relatively high level of physical activity, low prevalence of daily smoking, and moderate alcohol drinking. The above-average overweight/obesity prevalence among platelet donors in this cohort is of concern because of the potential serious health consequences and it warrants further reflection.

Healthy Behavior Adherence: The National Health and Nutrition Examination Survey, 2005–2016

Leading public health institutions recommend participation in several evidence-based behaviors, including exercise, a healthy diet, and maintenance of a normal BMI while simultaneously avoiding cigarette smoking and excessive alcohol consumption. The investigators attempted to evaluate the collective adherence to these recommendations and population trends in these behaviors by evaluating nationally representative surveys over a period of 12 years. In 2019, the data from 26,194 National Health and Examination Survey participants who provided answers to survey questions regarding diet, physical activity, and usage of cigarettes and alcohol were analyzed. BMI was obtained from the examination data. Adherence to each behavior and the constellation of all 5 behaviors was assessed and tracked over a 12-year timeframe. The smoking rates (p=0.01) and adherence to a healthy BMI declined over time (p=0.03). The total percentage of subjects who participated in all 5 behaviors ranged from 4.4% to 6.3%, whereas subjects who performed 2 or fewer behaviors ranged from 45.4% to 48.3%. Greater education (p<0.0001), higher SES (p<0.0001), and being a female participant (p<0.0001) predicted higher behavior scores. Only 1 in 5 Americans engage in 4 or more healthy behaviors, whereas almost half of them participate in fewer than 3 healthy behaviors. Increased participation in numerous healthy behaviors can decrease premature mortality, decrease the burden of chronic diseases, improve life quality, and provide substantial economic benefits. A public health practice of targeting a constellation of behaviors as opposed to individual behaviors is needed.

Effect of lifestyle and dietary factors in the development of brain tumors.

Introduction:A brain tumor occurs when neurons are mutated and thus abnormal cells are formed. Glioma and meningioma are the two most common types, comprising approximately 75% of all brain tumors. The incidence rate of all primary brain tumors was 15.80/100,000 person-years in females and 14.33/100,000 person-years in males. An association of higher risk of brain tumors in adults with cured meat and fruit/vegetable consumption, the primary source of dietary N-nitroso compounds, is seen. Cigarette smoking is a major source of chemical carcinogens. The present study aimed at determining the effects of lifestyle and dietary habits in the development of brain tumor.Methods:The study aimed at the assessment of various dietary factors, lifestyle, and occupational and personal habits in patients diagnosed with brain tumor in a rural tertiary health-care hospital, using a structured questionnaire and statistical analysis.Results:It was observed that – (1) people with stressful, sedentary lifestyle and wrong diet and those addicted to alcohol consumption and the habit of cigarette smoking have higher risk of brain tumors; (2) males are more prone to brain tumors; and (3) among subtypes, majority had glioblastoma and the least had meningioma and opdivoglioblastoma and according to location, majority had cerebellopontine angle tumor and the least had left thalamic glioma and multicentric glioma. Primary care to preoperative brain tumor patients should be given in terms of preventing exposure to radiations, avoiding cigarette smoking, providing healthy diet, and avoiding chronic stress and environmental pollution and postoperative patients should be taken care including avoiding infections by maintaining proper hygiene and providing healthy diet for their speedy recovery.Conclusion:People with stressful life condition, wrong diet, and sedentary lifestyle and those addicted to alcohol, with the habit of cigarette smoking, have higher risk of brain tumors. Males are more prone to brain tumors.

Education Level and Cigarette Smoking: Diminished Returns of Lesbian, Gay and Bisexual Individuals.

Background: Education level is one of the strongest protective factors against high-risk behaviors such as cigarette smoking. Minorities’ Diminished Returns (MDRs), however, suggest that the protective effects of education level tend to be weaker for racial and ethnic minority groups relative to non-Hispanic White people. Only two previous studies have shown that MDRs may also apply to lesbian, gay, and bisexual (LGB) individuals; however, these studies have focused on outcomes other than tobacco use. Aims: To compare LGB and non-LGB American adults for the effects of education level on cigarette-smoking status. Methods: Population Assessment of Tobacco and Health (PATH; 2013) entered 31,480 American adults who were either non-LGB (n = 29,303, 93.1%) or LGB (n = 2,177; 6.9%). The independent variable was education level. The dependent variable was current established cigarette smoking. Race, ethnicity, age, gender, poverty status, employment, and region were the covariates. LGB status was the moderator. Results: Overall, individuals with higher education level (odds ratio (OR) = 0.69) had lower odds of current established smoking. We found a significant interaction between LGB status and education level suggesting that the protective effect of education level on smoking status is systemically smaller for LGB people than non-LGB individuals (OR for interaction = 1.19). Conclusions: Similar to the patterns that are shown for racial and ethnic minorities, MDRs can be observed for the effects of education level among sexual minorities. In the United States, highly educated LGB adults remain at high risk of smoking cigarettes, a risk which is disproportionate to their education level. In other terms, high education level better helps non-LGB than LGB individuals to avoid cigarette smoking. The result is a relatively high burden of tobacco use in highly educated LGB individuals.

Colorectal cancer rates are rising in younger adults.

Colorectal cancer rates are rising in younger adults.

Is Optimism Associated With Healthier Cardiovascular-Related Behavior? Meta-Analyses of 3 Health Behaviors.

Optimistic people have reduced risk for cardiovascular disease and cardiovascular-related mortality compared with their less optimistic peers. One explanation for this is that optimistic people may be more likely to engage in healthy behavior like exercising frequently, eating fruits and vegetables, and avoiding cigarette smoking. However, researchers have not formally determined the extent or direction of optimism's association with health behaviors. Moreover, it is unclear whether optimism temporally precedes health behaviors or whether the relationship is because of shared common causes. We conducted random effects meta-analyses examining optimism's association with 3 health behaviors relevant for the prevention of cardiovascular disease. PubMed and PsycINFO databases were searched for studies published through November 2017 reporting on optimism's relationship with physical activity, diet, and cigarette smoking. We identified 34 effect sizes for physical activity (n=90 845), 15 effect sizes for diet (n=47 931), and 15 effect sizes for cigarette smoking (n=15 052). Findings suggested that more optimistic individuals tended to engage in healthier behaviors compared with less optimistic individuals, but effect sizes were modest (ractivity=0.07, P<0.0001; rdiet=0.12, P<0.0001; and rsmoking=0.07, P=0.001). Most evidence was cross-sectional (≥53% of effect sizes) and did not consider sociodemographic characteristics (<53% of effect sizes) or psychological distress (<27% of effect sizes) as potential confounders. Optimism is associated with healthier behaviors that protect against cardiovascular disease, although most evidence was relatively low quality. Additional longitudinal and experimental research is required to determine whether optimism causally contributes to healthy behaviors and whether optimism could be an effective target for preventing cardiovascular disease.

Changes in CRP and TNF‐a after Runs at Different Intensities in Smokers Following Two Hour Cessation

The purpose of this study was to examine changes in C‐reactive protein (CRP) and TNF‐α from blood samples before and after exercise at different intensities in smokers (SM) and non‐smokers (NS) after a 2 hour smoking cessation. Our laboratory previously reported large differences in CRP and TNF‐α at Pre between SM and NS. Furthermore, there were more profound disturbances in SM following three runs at different intensities approximately 30 minutes after smoking cessation before each run (EB 2015, Boston). The previous findings indicated that SM responded more sensitively to relatively equal intensity of exercise, which suggested that high intensity aerobic exercise should be avoided in SM in the beginning phase of exercise training.MethodsA total of eighteen physically inactive subjects (eight SM and ten NS) aged 20 to 27 were recruited. Smokers were accepted if their level of exhaled carbon monoxide (eCO) was greater than 16 ppm. Each subject completed three treadmill runs at different intensities in a random order (55%, 65%, and 75% of VO2max). Running distance for all three runs was equivalent to 35‐min run at 65% VO2max. Smokers had a 2 hour smoking cessation before each run. Blood samples were collected before (Pre), immediately post (IP), and an hour following each run (1h Post).ResultsPre‐exercise CRP levels were higher in SM as compared to the NS. (2.291±.27 mg/L Vs. 2.082±.25, mean±SE, P = 0.042). As compared to Pre, no significant changes were found in CRP at IP and 1h Post following runs at three different intensities in both SM and NS. TNF‐α showed higher pre‐exercise levels in SM compared to NS (32.565±4.28 mg/L vs. 27.732±3.34, P=0.027). TNF‐α was significantly increased at IP following 75% of VO2max run in both SM and NS (SM: 32.657±4.36 → 38.797±6.33, P=0.013; NS: 27.694±3.26 → 33.466±4.35, P=0.019), but not significantly changed at IP following 55% and 65% of VO2max runs.ConclusionFindings of the current study revealed a dose‐response relationship for CRP and TNF‐a in SM and NS. The patterns of changes corresponded with previous presentation (EB, 2015) with a 30 minute smoking cessation; however, the differences between SM and NS were much smaller in this study suggesting that smokers may need to avoid cigarette smoking before exercise to minimize immune disturbance caused by combined stress from exercise and chronic smoking.Support or Funding InformationThis study was supported by Texas A&amp;M International University Research Grant.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Gender differences in snus versus nicotine gum for cigarette avoidance among a sample of US smokers

IntroductionWomen are more susceptible to the harmful effects of cigarette smoking. Thus, identifying effective harm reduction approaches for women is necessary. The goal of this project was to examine gender differences in response to snus versus nicotine gum for cigarette avoidance, as a means of harm reduction. MethodsParticipants were randomly assigned to use snus or nicotine gum as a method to avoid cigarette smoking. Participants attended clinic visits to receive study product, as well as provide biological samples to assess smoking avoidance and biomarkers and report on use of study product and cigarettes. A secondary analysis comparing men and women by randomization to study product was conducted. ResultsParticipants (n=391; 47% women) were randomized into the snus group (n=196; 45% women) and the gum group (n=195; 49% women). Men used more snus whereas women used more gum (p=0.02). During treatment, men in the snus group had higher total nicotine equivalent values whereas women did not vary by group (p=0.03). Overall, fewer men in the snus group completely avoided cigarettes compared to men in the gum group (e.g., continuous abstinence at Week 12: odds ratio=0.43, 95% confidence interval=0.20–0.93). Among women, there were no differences by randomization in cigarette avoidance. ConclusionsDespite a number of gender differences in response to snus versus nicotine gum, these data suggest that snus may not be an optimal harm reduction approach for either gender.

Towards research-tested smartphone applications for preventing breast cancer.

Efforts to prevent breast cancer and other chronic illnesses have focused on promoting physical activity, healthy diet and nutrition, and avoidance of excessive alcohol consumption. Smartphone applications (apps) offer a low-cost, effective strategy for breast cancer prevention in women through behavioral change. However, there are currently no research-tested smartphone apps for breast cancer prevention that are suitable for women with varying levels of health literacy and eHealth literacy. In this perspective, we consider modifiable risk factors for breast cancer in women in relation to the development of smartphone apps to promote healthy behaviors associated with breast cancer-risk reduction. First, we provide a summary of breast cancer risk factors that are modifiable through behavioral change including their corresponding relative risk. Second, we discuss scientific issues related to the development of smartphone apps for the primary prevention of breast cancer and offer suggestions for further research. Smartphone apps for preventing breast cancer should be tailored for women at different life stages (e.g., young women, women who are post-menopausal, and older women). Topics such as breastfeeding and oral contraceptives are appropriate for younger women. Weight management, physical activity, avoiding cigarette smoking, and dispelling breast cancer myths are appropriate for women of all ages. As women age, topics such as hormone replacement therapy or comorbid health conditions become more important to address. Apps for breast cancer prevention should be grounded in a behavioral theory or framework and should be suitable for people with varying levels of health literacy. Future developments in smartphone apps for breast cancer prevention should include apps that are tailored for specific cultural, racial, and ethnic groups.

Physicians' Counseling of Adolescents Regarding E-Cigarette Use

PurposeElectronic cigarette (e-cigarette) use now surpasses the use of conventional cigarettes among U.S. adolescents. Given the important role of physicians in preventing adolescent risk behaviors, we sought to understand how physicians communicate about e-cigarettes when counseling adolescent patients and their parents. We also explored physicians' support for regulations aimed at discouraging adolescents' e-cigarette use. MethodsA national U.S. sample of 776 pediatricians and family medicine physicians who provide primary care to adolescent patients completed an online survey in Spring 2014. ResultsMany physicians (41%) would, if asked, tell their patients that e-cigarettes are less harmful than cigarettes, and a substantial minority (24%) would recommend e-cigarettes to adolescents for smoking cessation. Most physicians reported routinely screening adolescent patients for cigarette smoking but few routinely screened for e-cigarette use (86% vs. 14%; p < .001). Routine counseling was similarly more common for avoiding cigarette smoking than for avoiding e-cigarette use (79% vs. 18%; p < .001). Support for government regulation of e-cigarettes was high, with 91% of physicians endorsing policies that prevent minors from buying e-cigarettes. ConclusionsPhysicians infrequently screen or counsel their adolescent patients about e-cigarette use, although e-cigarettes often come up during visits. Additional efforts by physicians could help prevent future use by adolescents. Recommending e-cigarettes as a smoking cessation aid to adolescent patients is inadvisable given the lack of evidence for efficacy in that population. As federal regulation of e-cigarettes remains in limbo, pediatricians and family medicine physicians can offer a powerful voice for informing regulations aimed at reducing use by adolescents.

English

Cataract is the opacification of the crystalline lens and or its capsule. Senile cataract is the cataract occurring commonly in the elderly who are above 50 years of age. It is one of the major causes of blindness in both the developing and the developed countries. Cataracts which develop prior to age of 50 are defined as pre senile cataract. There may be several reasons for an individual to develop such pre senile cataract. Some of the major identified risk factors are ocular trauma, uncontrolled diabetes, nutritional deficiencies, environmental factors like chronic exposure to sunlight as in tropics, cigarette smoking, refractive errors like high myopia, chronic intake of certain drugs for some systemic illness and certain ocular inflammatory diseases. AIM AND OBJECTIVES: To determine the various types of pre senile cataract and to determine the common causes of pre senile cataract. DESIGN: Prospective Observational study. METHODS & MATERIALS: The patients attending the out-patient clinics of the ophthalmology department who are found to have pre senile cataract and who give consent to participate in the observational study are requested to fill the questionnaire and undergo a complete ocular examination. The type of cataract and any cause of the cataract formation identified from the questionnaire, examination or investigations done are documented and analyzed using frequency distribution. RESULTS: 100 eyes of 54 patients were included in the study. Most common type of cataract was found to be posterior sub capsular cataract. The common causes identified were sunlight exposure, chronic steroid use, diabetes, uveitis and smoking. CONCLUSION: Protection from sunlight, avoidance of chronic steroid usage, screening and adequate control of diabetes, meticulous management of uveitis and avoiding cigarette smoking helps to prevent early development of cataracts.

Physical activity and kidney diseases

Regular physical activity (PA) in the early school years is recommended by several scientific associations for primary prevention of cardiovascular disease. Long-term observational studies have shown that subjects who exercise regularly have significantly less coronary heart disease (CHD) and a reduced risk of cardiovascular disease (CVD). Exercise reduces serum triglycerides, increases serum high density lipoprotein-cholesterol, lowers the blood pressure in patients with primary hypertension [1]. Regular exercise reduces the production of atherogenic cytokines and increases production of atheroprotective cytokines. It should be mentioned, however, that other factors may be associated with physical activity (e.g. a healthy diet, avoiding cigarette smoking, regular medical care) and may contribute to the improved health. No long term studies have been produced on the effects of PA during childhood on CHD and CVD in adult life but indirect evidence suggests that it may produce benefit. Regular exercise, on the other end, is associated with potential adverse effects (eg, musculoskeletal injuries, arrhythmias, myocardial infarction, and rhabdomyolysis); however, the absolute risk of kidney disease during exercise is low [2]. Consensus guidelines for the pre-participation physical evaluation (PPE) suggest a PPE for all children, even those who do not participate in organized sports, as an opportunity to promote health and fitness. PPE includes a medical and family history and a physical examination, with particular emphasis on the musculoskeletal and cardiovascular systems [3]. Exercise induces profound changes in the renal haemodynamics and in electrolyte and protein excretion. Proteinuria, hematuria and changes in serum electrolyte balance have been reported during intense PA; the increase in glomerular filtration may explain these transient alterations but the “nutcracker” compression on the renal vein may have a role. Haemoglobinuria and myoglobinuria may be observed under special exercise conditions [4]. PA does not worse nor reverse kidney disease but may reduce cardiovascular risk in chronic renal disease [5]. Children on dialysis and after a renal transplantation performing aerobic physical exercise show improvements in exercise tolerance, in quality of health and uraemic symptom scores; they gain weight loss, cardiovascular reactivity, avoiding an increase in blood pressure medication [6].

Abstract 50: Oral Contraceptive Use and Incident Stroke in Women With Sickle Cell Disease

Background: Oral contraceptives increase the risk of ischemic stroke among women. However, the effect is not studied in the stroke prone sickle cell disease population. Objective: To determine the rate of incident stroke among women with sickle cell disease enrolled a large cohort with longitudinal follow-up. Methods: A total of 1263 women aged ≥15 and &lt;45 years, were enrolled in Phase 1 of Cooperative Study of Sickle Cell Disease from 23 centers across the US. Participants underwent a baseline examination for assessment of demographics, prior medical history, lab assessments, and clinical data. Post baseline data included routine follow-up examinations, measures of organ damage, and collection of acute and chronic complications. The effect of oral contraceptive use on incident stroke were assessed after adjusting for age, cigarette smoking, and history of exchange transfusion by Cox Proportional Hazards analysis. Results: A total of 281 (22.2%) of 1263 women with sickle cell disease reported use of oral contraceptives. There was no difference in the mean age (±SD) of the women who reported use compared with those without of oral contraceptives (27 ±6 versus 27±8, p=0.9). History of exchange transfusions (24.2 % versus 15.0 %, p=0.003) and cigarette smoking (24.7 % versus 18.5 %, p=0.03) were more common among women who report use of oral contraceptives. The age adjusted annual incidence of incident stroke among women who used oral contraceptives was four folds higher than those who did not report use (1.4% versus 0.3%, p= 0.04). After adjusting for exchange transfusion and cigarette smoking, oral contraceptive use was not associated with rate of ischemic stroke (HR, 0.3 95% CI 0.06-1.3, p= 0.2) or stroke free survival (HR, 0.98 95% CI 0.6-1.6, p= 0.9). Conclusions: The four fold higher risk of incident stroke associated with use of oral contraceptives in women with sickle cell disease can be mitigated by avoiding cigarette smoking.

Effects of Smoking on Chest Expansion, Lung Function, and Respiratory Muscle Strength of Youths

[Purpose] Smoking has a direct effect on the respiratory system. The rate of cigarette smoking among young people has continued to increase steadily. The present study quantified and compared the respiratory function of smoking and non-smoking youths. [Subjects] Smoking and non-smoking male participants aged between 15 to 18 years were recruited (n=34 per group). [Methods] Participants were asked to complete a questionnaire relating to smoking habits and the Fagerström test for nicotine dependence questionnaire, and their respiratory function was tested (measurement of chest expansion, lung function test with a spirometer, and assessment of respiratory muscle strength). [Results] All respiratory function tests demonstrated significant differences between the smoking and non-smoking groups. Smokers initiated cigarette smoking between the ages of 15 to 18 years. The most common duration of cigarette smoking was 1-3 years and the degree of nicotine dependence among the youths was at a low level. [Conclusion] This study’s findings show that the early effects of cigarette smoking found in youths can lead to problems with the respiratory system. Such information can be used to illustrate the harm of smoking and should be used to encourage young people to quit or avoid cigarette smoking.

Leadership Message: Government and Corporate Responsibility to Work With Academia About the Obesity Epidemic

Leadership Message: Government and Corporate Responsibility to Work With Academia About the Obesity Epidemic

Cigarette Smoking and the Development of Premenstrual Syndrome

Moderate to severe premenstrual syndrome (PMS) affects as many as 20% of premenopausal women. Although smoking may be more common in women with PMS, it is unknown whether smoking is involved in PMS etiology. In 1991-2001, the authors conducted a case-control study nested within the prospective Nurses' Health Study II. Participants were US women aged 27-44 years and free of PMS at baseline, including 1,057 who developed PMS over 10 years and 1,968 reporting no diagnosis of PMS and only minimal menstrual symptoms during this time. Smoking at various ages was assessed by questionnaires. After adjustment for oral contraceptives and other factors, current smokers were 2.1 times as likely as never smokers to develop PMS over the next 2-4 years (95% confidence interval: 1.56, 2.83). Total pack-years and smoking during adolescence and young adulthood were also independently associated with a higher risk of PMS. For example, the relative risk for women who started smoking before age 15 years, compared with never smokers, was 2.53 (95% confidence interval: 1.70, 3.76). Results suggest that smoking, especially in adolescence and young adulthood, may increase risk of moderate to severe PMS. These findings may provide an additional incentive for young women to avoid cigarette smoking.

Head and neck squamous cell cancer as part of the germline p16/INK4a mutation-induced FAMMM syndrome

6052 Background: p16/INK4a constitutes an important cancer susceptibility locus. Germline mutations at this locus have been implicated in several human cancer syndromes, including familial atypical multiple mole melanoma (FAMMM) syndrome, FAMMM-pancreatic cancer (FAMMM-PC) syndrome, and more recently, in familial head and neck cancer syndrome. Methods: We present an individual with a family history of both pancreatic cancer and melanoma, who developed squamous cell carcinoma of the tongue at 21 years old, multiple melanomas, a second squamous cell cancer of the tongue at 40 years old, and ultimately a pancreatic cancer. Results: We identify a germline mutation in INK4a that leads to a substitution of tryptophan for glycine in the Ankyrin III domain of the p16 protein (G101W). We demonstrate loss of heterozygosity at the INK4a locus and lack of p16 expression in the second head and neck squamous cell cancer (HNSCC) tissue. Based on these and on previously published data, we propose that HNSCC resulting from an INK4a germline mutation is a variant of the FAMMM/FAMMM-PC syndrome. Further studies will determine whether there is genotype-phenotype correlation between these syndrome variants. Conclusions: We conclude that young individuals who develop HNSCC should be considered at high-risk for other cancers, including pancreatic cancer and melanoma. They should be advised to avoid cigarette smoking and should be considered for pancreas cancer screening. No significant financial relationships to disclose.

Cancer risk perceptions in an urban Mediterranean population

The objective of our study was to analyze the perceived (belief) or adopted (behavior) measures to reduce cancer risk in a Spanish population. We used cross-sectional data from the Cornella Health Interview Survey Follow-up Study (CHIS.FU). We analyzed 1,438 subjects who in 2002 answered questions about risk perceptions on cancer and related behavior (668 males and 770 females). The benefits of avoiding cigarette smoking (95.8%), sunlight exposure (94.9%) and alcohol (81.0%) were widely recognized. On the other hand, electromagnetic fields (92.1%), food coloring and other food additives (78.4%) or pesticides (69.4%), whose role in cancer occurrence, if any, remain unproven, were clearly considered as cancer risk factors in this population. Compared to men, women more frequently reported healthy behaviors, and the role of exogenous factors (i.e., environmental risk factors) were widely popular. There was a socioeconomic gradient on cancer risk perception with respect to several lifestyle or dietary factors. Individuals with higher educational level scored lower in several risk factors than those with primary or less than primary school education. Smokers reported adopting fewer healthy behaviors than former or never smokers. How people perceive health issues and risk or make choices about their own behavior does not always follow a predictable or rational pattern.

Causes and clinical characteristics of chronic cor-pulmonale in Ethiopia

To determine the clinical characteristics and underlying causes of chronic cor-pulmonale in Ethiopian patients. A hospital based cross-sectional study. Tikur Anbessa Hospital, a large referral hospital in Addis Ababa, Ethiopia. Fourty two consecutive patients referred to the chest clinic of Tikur Anbessa Hospital, Addis Ababa, Ethiopia. Bronchial asthma (36%), chronic fibrocavitary tuberculosis (31%) and chronic bronchitis/emphysema (33%) were the most frequent underlying causes and occurred either singly or in combination in 36(86%) of patients. Interstitial lung disease occurred in five (11.9%) patients. Right-sided heart failure and cyanosis were the most common clinical presentations. Secondary polycythemia was noted in 32 of 40 patients (80%). The role of pulmonary vascular diseases including pulmonary schistosomiasis as a cause of pulmonary heart disease could not be ascertained but appeared to be insignificant. Chronic persistent asthma is a frequent underlying cause of chronic obstructive pulmonary disease and chronic cor-pulmonale compared to smoking related chronic bronchitis/emphysema in Ethiopia. The preventive strategy of chronic cor-pulmonale includes optimal treatment of bronchial asthma, early diagnosis and effective treatment of tuberculosis and health education to avoid cigarette smoking.